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ARCHIVED REPORTS_XR0012576
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545483
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ARCHIVED REPORTS_XR0012576
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Entry Properties
Last modified
3/10/2020 9:04:49 PM
Creation date
3/10/2020 10:57:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012576
RECORD_ID
PR0545483
PE
3528
FACILITY_ID
FA0005939
FACILITY_NAME
MANTECA MULTIMODAL STATION
STREET_NUMBER
260
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
22102024
CURRENT_STATUS
02
SITE_LOCATION
260 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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- - s = _ , <br /> _ s;:. <br /> r� <br /> r� <br /> "iP'pAAooF' 1AusrEES SAN JOAOUIN LOCAL. F1EAL.TFI DISTRICT SEAVINO <br /> 1:a:: CEII or LAdI <br /> moo <br /> Culnrrlsan, Pies. <br /> F;IaIe,E. Vannued,Sear 1601 East HaZellan Avenup, P O. Dox 2009 Sa^Joaquin Counlr <br /> qelks Yarn 5pronson <br /> city at Escolon <br /> Stockton,Gaillorntn 97701 City of Mantac♦ <br /> 209/466-6781 <br /> City of Rlpon <br /> i rn:8upboa. <br /> {�,t►IW�. Fluraa C1tY of Stockton <br /> p,jAell. M.O. <br /> y "J.-Wada <br /> CIEy o!Tracy <br /> ��,lt!. ).1lYede Jopl Khanna, M.O., M.P.H., 0Ea1ricl Haab"0111"t San Joaqulncounty <br /> "'i <br /> ry nr 4nns Lova San Joaquin Caun:y <br /> h AUTHORIZATION TO RELEASE ANALYTICAL RESULTS, GEOTECHNICAL DATA AND <br /> SITE ASSESSMENT INFORMATION <br /> 1, the undersigned owner and/or operator of the property and/or facility <br /> located at 260 S. Main Street, Manteca, CA <br /> .hereby authorize Canonie Environmental , Stockton, CA <br /> *" release any and all analytical results, geotechnical data and site <br /> ... ,,.aessment information to the San Joaquin Local Health District as soon <br /> :as it is available and at the same time it is provided to me or. my <br /> 14entati ve. <br /> a,mAer/Operator: ,� Jc" !r') (_ ?,/ _Title: <br /> Ades (1 `� Phone: <br /> drs1--�/ <br /> ! r r <br /> 08 o5- UGT 13 <br /> z <br /> 00111 <br />
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